The Effect of Interventions for Improving Health and Academic Outcomes on Disadvantaged Primary School Children

• In Event: Schools as Enabling Spaces to Improve Learning and Health Outcomes in Rural South Africa — Part 2

Abstract

"The overwhelming research evidence is unambiguous in concluding that the programmes, funding and interventions intended to improve objective health behaviour and wellbeing outcomes in
Background: Relatively little evidence has been synthesised showing the effects of primary school community-based interventions to improve academic and mental health outcomes pupils attending schools in socio-economically disadvantaged rural communities.

Objective: The purpose of this review was to examine the ‘treatment’ effect of school-community based interventions on mental health and academic outcomes in socio-economically disadvantaged primary school children. The primary review question was: What is the effectiveness of school community-based interventions to improve academic and mental health outcomes in pupils attending schools in socio-economically disadvantaged rural communities?

Method: The authors employed a Systematic Evidence Synthesis of published empirical papers testing interventions to improve academic and mental health outcomes meeting specific inclusion criteria.

Results: Twenty-five papers were included: 5 Randomised controlled trials and 20 cohort studies. Studies had sample sizes ranging from 62 to 910, mean = 284, with interventions directed at pupil, teachers or parents, or a combination of all three. Most interventions improved pupils’ emotional literacy and problem-solving skills, social competence, maths ability, attention, engagement, social and emotional knowledge, emotional risk, interpersonal reactivity, peer likeability, and children’s wellbeing. Interventions also decreased behavioural problems, aggression, conduct, and disruptive behaviour generated for problem solving. Most cohort studies reported positive results on children’s outcomes in reducing aggression and disruptive behaviour. Parental mental health also improved, and those interventions targeted at teachers improved their competence and use of evidence-based practice. Whilst most cohort studies improved outcomes, some interventions had no significant effect on children’s social mapping, peer relations, social skills and physical health outcomes. The quality of the RCTs was assessed as close to strong; cohort studies were rated moderate to weak.

Conclusions: Interventions to improve socio-economically disadvantaged primary school pupils’ academic, mental health and wellbeing, and behavioural outcomes are mostly effective. Those targeted at pupils’ social competence, emotional regulation and conduct issues produce the biggest improvements. Notwithstanding these positive findings and considering the quality of some of the studies reviewed, better designed trials testing these interventions are also needed. Focus on specific individual behaviour change. It is no surprise that many struggle to trace longer-term, sustainable impact on practice or policy. Importantly, schools tend to be treated as ‘settings’ for discrete health interventions (i.e., as access to target population), rather than being a health intervention in their own right to enable children to learn to live meaningful, healthy and resilient lives. Yet, emerging evidence suggests that to achieve sustainable impact on children in vulnerable communities, improving the health-related quality of life must go together (e.g. Marmot, 2010, 2014 & 2015), and must involve systemically-connected action to empower teachers, schools and their local communities (e.g. Atkins et al, 2016; Carey et al., 2015). "

Authors

• Patrick Callaghan, London South Bank University

• Huiming Ding, University of Leeds

• Qing Gu, University College London Institute of Education

• Liesel Ebersohn, University of Pretoria